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Bellini duct (collecting duct) carcinoma of the kidney
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| Collecting duct carcinoma of the kidney is rare and its biological behavior is not well known. 5 cases of collecting duct carcinoma(3 males and 2 females,age 41～67 years)were identified in the last 4 years.The clinical,pathologic and immunohistochemical characteristics of these tumors were presented.The most common symptoms were hematuria, fatigue,marasmus and low fever.4 patients underwent radical nephrectomy,of those 3 have been alive without evidence of recurrence for 3 months,2 and 2.5 years,respectively,whereas... Collecting duct carcinoma of the kidney is rare and its biological behavior is not well known. 5 cases of collecting duct carcinoma(3 males and 2 females,age 41～67 years)were identified in the last 4 years.The clinical,pathologic and immunohistochemical characteristics of these tumors were presented.The most common symptoms were hematuria, fatigue,marasmus and low fever.4 patients underwent radical nephrectomy,of those 3 have been alive without evidence of recurrence for 3 months,2 and 2.5 years,respectively,whereas 1 died of lung metastasis 14 months after operation.One patient was submitted to simple nephrectomy because of extensive regional nodal invasion and bone metastasis was noted 2 months afterwards.Grossly the tumor had a whitish appearance with the bulk of the mass located in the renal medulla.Histologic examination showed prominent tubulo-papillary structures.Marked desmoplastic reaction was noted and atypical hyperplastic changes were found in the adjacent collecting ducts.Immunohistochemical studies revealed positivity with antibodies to epithelial membrane antigen,high molecular weight cytokeratins and peanut agglutinin,With a review of the literature some issues concerning the diagnosis and management of these tumors were discussed. | 肾集合管癌少见，其生物学行为尚不十分清楚。我们在近４年间收治５例，男３例，女２例，年龄４１～６７岁。主要临床表现为血尿、消瘦、低热。４例行根治性肾切除术，３例分别经３个月，２、２．５年随访无复发，ｌ例术后１年２个月死于肺转移。１例因肾门、腔静脉旁淋巴结广泛受累仅作姑息性肾切除，术后２个月出现骨转移。病理所见：肿瘤灰白，位于髓质，镜检呈腺管乳头状结构，间质丰富，邻近集合管异型增生。免疫组化检查高分子细胞角蛋白，花生凝集素及上皮细胞膜抗原均阳性。结合文献对集合管癌的若干诊断和治疗问题进行讨论。 | Objective To study the clinicopathologic characteristics of renal collecting duct carcinoma(CDC). [WT5”HZ]Methods A retrospective study was done in 10 cases of CDC. Results Among 466 cases of renal cell carcinoma admitted in our Institute between January 1989 and June 30, 1999, 10(21%) cases of CDC were identified. Seven presented with gross hematuria and 3 with abdominal pain. Radical nephrectomy was done in 9 patients,enucleation of tumor in one. The primary tumor was located predominantly in the renal... Objective To study the clinicopathologic characteristics of renal collecting duct carcinoma(CDC). [WT5”HZ]Methods A retrospective study was done in 10 cases of CDC. Results Among 466 cases of renal cell carcinoma admitted in our Institute between January 1989 and June 30, 1999, 10(21%) cases of CDC were identified. Seven presented with gross hematuria and 3 with abdominal pain. Radical nephrectomy was done in 9 patients,enucleation of tumor in one. The primary tumor was located predominantly in the renal medulla. Histologic examination showed prominent tubular or tubulopapillary structures. Sarcomatoid carcinoma, cystadenocarcinoma, nests and cords of tumor cells in desmoplastic stroma were identified in some cases. High molecular weight cytokeratin 34 β E12 was positive in 8 cases and peanut agglutinin in 7 cases. According to Fuhrman′s nuclear grade, one was in G2, 4 were in G3 and 5 in G4. Six patients died of metastases within 3 to 23 months(mean 133 months), one died of heart disease with tumor free after 19 months, two survived with tumor free for 14 months and 39 months, respectively, one lost from followup. Conclusion CDC is a distinctive renal cell carcinoma with prominent clinical appearance and progressive clinical course. | 目的 研究肾集合管癌的临床病理特征。方法 回顾性研究肾集合管癌的临床及病理资料并进行随访。结果 10例肾集合管癌占肾癌的 2 1%。主要症状为血尿、腰腹痛。 9例行肾癌根治术 ,1例行肿瘤剜除术。肿瘤主要位于肾髓质 ,呈灰白色或淡黄色 ,侵袭性生长 ;以腺管乳头状结构为主 ,部分混有肉瘤样癌、腺样囊性癌、条索及巢状癌。Fuhrman病理分级 :G2 ,1例 ;G3,4例 ;G4,5例。TNM综合病理分期 :Ⅰ期 4例 ,Ⅱ期 2例 ,Ⅲ期 1例 ,Ⅳ期 3例。 6例死于肾癌转移 ,其中 1例术后19个月死于心脏病 ;2例无瘤生存 ;1例失访。平均生存时间 13 3个月。结论 肾集合管癌临床症状明显 ,临床病理分期高 ,进展快。主要治疗方法为肾癌根治术 ,多数病例于术后数月发生转移或死亡。 | Purpose To study the clinicopathologic characteristics of renal collecting duct carcinoma(CDC). Methods A retrospective study was done in 8 cases of CDC. Results CDC showed an old male predominance. The major manifestations of the patients were hematuria,flank pain and abdominal mass. The primary tumor was centrally located in the renal medulla and appeared gray or white. Histologic examination showed prominent tubular or tubulopapillary structures. Frequently,cells with a hobnail pattern were present.Collecting... Purpose To study the clinicopathologic characteristics of renal collecting duct carcinoma(CDC). Methods A retrospective study was done in 8 cases of CDC. Results CDC showed an old male predominance. The major manifestations of the patients were hematuria,flank pain and abdominal mass. The primary tumor was centrally located in the renal medulla and appeared gray or white. Histologic examination showed prominent tubular or tubulopapillary structures. Frequently,cells with a hobnail pattern were present.Collecting ducts near the tumor usually showed dysplastic changes. According to Fuhrman's nuclear grade,1 was in G 2,4 in G 3 and 3 in G 4. pTNM stage:1 in stage Ⅰ, 1 in stage Ⅱ,4 in stage Ⅲ and 2 in stage Ⅳ. Three patients died within 9～17 months(mean 13 months) after operation,2 survived for 13 and 60 months,respectively, and 3 were lost from follow up. Conclusion CDC is a poor prognosis tumor with progressive clinical course and high pTNM stage and Fuhrman's nuclear grade. | 目的 研究肾集合管癌的临床病理特征。方法 回顾性研究 8例肾集合管癌的临床、病理资料并进行随访。结果 肾集合管癌好发于老年男性 ,主要症状是血尿、腰痛、体检发现肿块 ;肿瘤主要位于肾中极髓质处 ,呈灰白或灰黄色 ,侵袭性生长 ;以腺管或腺管乳头状结构为主 ,可见“鞋钉样”结构 ,周围肾组织集合管可出现异型增生或原位癌 ;Fuhrman细胞核分级 :G2 ,1例 ;G3 ,4例 ;G4,3例。pTNM分期 :Ⅰ期 1例 ,Ⅱ期 1例 ,Ⅲ期 4例 ,Ⅳ期 2例。 3例术后 9～ 17个月死亡 ,平均生存时间13个月 ;2例术后 13、6 0个月仍存活 ;3例失访。结论 肾集合管癌pTNM分期及Fuhrman细胞核分级高 ,进展快 ,预后差 ,多数病人术后数月死亡 | | | | << 更多相关文摘 |
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肾集合管癌
collecting duct carcinoma of the kidney
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